1.Construction and analysis of a sepsis model of rat after liver transplantation
Zhiwei XU ; Shubin ZHANG ; Qian LIU ; Yi ZHANG ; Yiming HUANG ; Pusen WANG ; Lin ZHONG
Organ Transplantation 2026;17(3):432-443
Objective To establish a stable and reliable sepsis model of rat after liver transplantation (LT) for clinical translational research and analyze its characteristics. Methods The "two-sleeve method" was used to establish the in situ LT model of SD rats, and the sepsis model was constructed through cecal ligation and puncture (CLP) at 3 d after the operation. SD rats were randomly divided into 3 groups: sham operation group (Sham group), LT group, and LT + CLP group, with 6 rats in each group. The changes in body weight, rectal temperature and survival rate were compared, and the sepsis score was used for evaluation. The levels of blood biochemical indicators [alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea (Urea), creatinine (Cr), creatine kinase (CK), lactate dehydrogenase (LDH)] and inflammatory factors [interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor (TNF)-α] in each group were detected, and the pathological changes and cell apoptosis in different organs were observed. Results Compared with the Sham group, the body weight of the LT group and LT + CLP group decreased (all P<0.05). The rectal temperature of the LT + CLP group showed a continuous downward trend after the operation, the sepsis score increased sharply after the operation, and the survival rate dropped to 16.7%, and the differences between the Sham group, LT group and LT + CLP group were statistically significant (all P<0.05). The levels of ALT, AST, Urea, Cr, CK, LDH, and serum IL-1β, IL-6, IL-10 and TNF-α in the LT + CLP group were higher than those in the Sham group and LT group rats within 72 hours after the operation(all P<0.05). The pathological examination of the LT + CLP group showed severe tissue structure destruction, necrosis and infiltration of inflammatory cells in multiple organs, and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining showed an increased level of cell apoptosis in multiple organs. Conclusions Using liver transplantation combined with CLP, a stable animal model of liver transplantation infection is successfully established, which exhibits a high mortality rate, significant multi-organ damage and intense inflammatory response, providing an ideal animal model for transplantation infection research.
2.Flos Buddlejae self-heating steam eye mask combined with sodium hyaluronate eye drops in the treatment of dry eye disease
Zhaodan TAN ; Qian LI ; Yan SHI ; Kangyuan HU ; Jin HUANG
Journal of Pharmaceutical Practice and Service 2026;44(2):96-102
Objective To assess the clinical efficacy of sodium hyaluronate (0.3%) eye drops combined with herbal self-heating steam eye mask in the treatment of dry eye disease. Methods A prospective randomized controlled clinical trial was performed on 60 patients diagnosed with dry eye at the ophthalmic clinic of a Grade A, Class Ⅲ hospital in Shanghai from June 2023 to September 2024. Specifically, patients were randomly divided into control group and study group. Patients in the control group were treated with sodium hyaluronate (0.3%) eye drops for six weeks; while in the study group, patients received the eye drops combined with the herbal self-heating steam eye mask mainly containing powders of Flos Buddlejae. Subsequently, comparisons and analysis were performed before and after treatment between the two groups in the clinical symptom questionnaire score traditional Chinese medicine (TCM syndrome score),the Chinese dry eye questionnaire score and determination of tear film fluorscein breakup time (FBUT), and curative effect. Results The quality control standard of the herbal powder in the self-heating steam eye mask was established through TLC and HPLC, and good heating behavior of the herbal self-heating steam eye mask was ascertained heating temperature (43±5)℃; heating duration (≥20 min), meeting requirements of the product quality control. After treatment for 6 weeks, FBUT was increased, while TCM syndrome score and the Chinese dry eye questionnaire score were both decreased in the study group (P<0.001). Besides, compared with the control group, TCM syndrome score and the Chinese dry eye questionnaire score were much lower, while the FBUT were higher in the study group (P<0.001). Moreover, the overall response rate in the study group (81.7%) was much better than that in the control group (25.9%). Conclusion The combination of sodium hyaluronate (0.3%) eye drops with herbal self-heating steam eye mask could be applied to the clinical treatment of dry eye disease due to its good clinical effects on relieving dry eye symptoms.
3.Changes in contrast-enhanced computed tomography quantitative parameters and their relationships with pathological grades in patients with clear cell renal cell carcinoma
Gang ZHOU ; Rong HUANG ; Qian CHENG
Chinese Journal of Radiological Health 2026;35(1):49-55
Objective To explore the change pattern of quantitative parameters in contrast-enhanced computed tomography (CECT) scans during the cortical and nephrographic phases in patients with clear cell renal cell carcinoma (ccRCC), evaluate the diagnostic efficiency of these quantitative parameters in predicting the pathological grade of ccRCC preoperatively, and provide imaging reference for clinically evaluating preoperative disease severity and formulating individualized therapeutic regimens. Methods A retrospective analysis was performed on the clinical data of 84 patients with ccRCC treated in our hospital between September 2022 and September 2024. According to the World Health Organization/International Society of Urological Pathology (WHO/ISUP) pathological grading system, patients were divided into a high-grade group (n = 32) and a low-grade group (n = 52). CECT features and quantitative parameters were compared between the two groups. The relationships between CECT quantitative parameters and pathological grading in ccRCC patients were analyzed using Spearman correlation. The diagnostic value of these parameters for preoperative pathological grading was evaluated using receiver operating characteristic curves. Results The maximum tumor diameter and the proportion of tumors with blurred margins were higher in the high-grade group than in the low-grade group (P<0.05). The CT values, net enhancement values, and enhancement rates during both the cortical and nephrographic phases were lower in the high-grade group than in the low-grade group (P<0.05). Spearman correlation analysis showed that the CT values, net enhancement values, and enhancement rates during both the cortical and nephrographic phases were negatively correlated with preoperative pathological grades in ccRCC patients (P<0.05). Receiver operating characteristic curve analysis revealed that the area under the curve for preoperative pathological grading using the combination of cortical phase CT value, cortical phase net enhancement value, cortical phase enhancement rate, nephrographic phase CT value, nephrographic phase net enhancement value, and nephrographic phase enhancement rate was 0.912, which was higher than the areas for any individual parameter used alone (0.770, 0.748, 0.763, 0.751, 0.739, and 0.718, respectively; P<0.05). The sensitivity, specificity, and 95% confidence interval for the parameters used in combination were 96.88%, 69.23%, and 0.853-0.970, respectively. Conclusion CECT quantitative parameters were negatively correlated with pathological grades in patients with single ccRCC and demonstrated high diagnostic efficiency for pathological grading, providing a reference for clinical treatment planning.
4.Effect of Ligustilide on Neutrophil Extracellular Traps in Rats with Cerebral Ischemia-reperfusion Injury
Qian WU ; Yang WANG ; Jianing ZHOU ; Zhihan WAN ; Ke HU ; Qi HUANG ; Ning WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):82-88
ObjectiveTo explore the possible mechanisms by which ligustilide (LIG) exerts neuroprotective effects on ischemic stroke (IS) by inhibiting the release of neutrophil extracellular traps (NETs), promoting blood-brain barrier repair, and alleviating post-ischemic neuroinflammation, thereby providing a new direction for IS treatment. MethodsA middle cerebral artery occlusion (MCAO) model was established in rats. The rats were divided into the sham operation (Sham) group, model (Model) group, low- and high-dose LIG groups (20, 40 mg·kg-1), and the NET inhibitor CI-amidine group (CI-amidine, 10 mg·kg-1). Drug treatments were administered for 3 days. Neurological injury after ischemia was evaluated by 2,3,5-triphenyltetrazolium chloride (TTC) staining, neurological deficit scoring, and brain index measurement. Flow cytometry and Western blot were used to analyze changes in neutrophil expression. Immunofluorescence was used to observe the fluorescence intensity of the NET marker citrullinated histone H3 (H3Cit). Western blot was performed to detect the expression of blood-brain barrier tight junction-related proteins and inflammatory factors, including interleukin-18 (IL-18) and interleukin-1β (IL-1β). ResultsCompared with the Sham group, the Model group exhibited significant brain tissue injury (P<0.05), significantly increased neutrophil numbers and NET expression (P<0.05), significantly impaired blood-brain barrier permeability (P<0.05), and significantly increased expression of inflammatory factors (P<0.05). Compared with the Model group, both low- and high-dose LIG significantly alleviated brain tissue injury in rats (P<0.01), inhibited neutrophil numbers and NET expression (P<0.01), reduced blood-brain barrier damage (P<0.01), and suppressed the expression of inflammatory factors IL-18 and IL-1β (P<0.01), thereby ultimately exerting a neuroprotective effect. ConclusionThe neuroprotective effect of LIG in rats with cerebral ischemia-reperfusion injury may be related to inhibition of neutrophils and the NETs induced by them.
5.Effect of Ligustilide on Neutrophil Extracellular Traps in Rats with Cerebral Ischemia-reperfusion Injury
Qian WU ; Yang WANG ; Jianing ZHOU ; Zhihan WAN ; Ke HU ; Qi HUANG ; Ning WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):82-88
ObjectiveTo explore the possible mechanisms by which ligustilide (LIG) exerts neuroprotective effects on ischemic stroke (IS) by inhibiting the release of neutrophil extracellular traps (NETs), promoting blood-brain barrier repair, and alleviating post-ischemic neuroinflammation, thereby providing a new direction for IS treatment. MethodsA middle cerebral artery occlusion (MCAO) model was established in rats. The rats were divided into the sham operation (Sham) group, model (Model) group, low- and high-dose LIG groups (20, 40 mg·kg-1), and the NET inhibitor CI-amidine group (CI-amidine, 10 mg·kg-1). Drug treatments were administered for 3 days. Neurological injury after ischemia was evaluated by 2,3,5-triphenyltetrazolium chloride (TTC) staining, neurological deficit scoring, and brain index measurement. Flow cytometry and Western blot were used to analyze changes in neutrophil expression. Immunofluorescence was used to observe the fluorescence intensity of the NET marker citrullinated histone H3 (H3Cit). Western blot was performed to detect the expression of blood-brain barrier tight junction-related proteins and inflammatory factors, including interleukin-18 (IL-18) and interleukin-1β (IL-1β). ResultsCompared with the Sham group, the Model group exhibited significant brain tissue injury (P<0.05), significantly increased neutrophil numbers and NET expression (P<0.05), significantly impaired blood-brain barrier permeability (P<0.05), and significantly increased expression of inflammatory factors (P<0.05). Compared with the Model group, both low- and high-dose LIG significantly alleviated brain tissue injury in rats (P<0.01), inhibited neutrophil numbers and NET expression (P<0.01), reduced blood-brain barrier damage (P<0.01), and suppressed the expression of inflammatory factors IL-18 and IL-1β (P<0.01), thereby ultimately exerting a neuroprotective effect. ConclusionThe neuroprotective effect of LIG in rats with cerebral ischemia-reperfusion injury may be related to inhibition of neutrophils and the NETs induced by them.
6.Molecular Crosstalk Mechanisms of Shoutai Wan and Juyuan Jian on Maternal-fetal Interface Subcellular Clusters in CBA/J×DBA/2 Recurrent Pregnancy Loss Model
Jingxin GAO ; Qiuping CHEN ; Xiaoyan ZHENG ; Pengfei ZENG ; Rui ZHOU ; Yancai TANG ; Qian ZENG ; Wenli GUO ; Jinzhu HUANG ; Weijun DING ; Linwen DENG ; Hang ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):70-87
ObjectiveTo systematically compare the differential regulation of the maternal-fetal interface cell lineages and communication networks in the CBA/J×DBA/2 mouse model of recurrent pregnancy loss (RPL) by the two classic therapeutic methods-tonifying the kidney to stabilize the fetus and invigorating the spleen to stabilize the fetus (Shoutai Wan, Juyuan Jian)-of traditional Chinese medicine (TCM) at the single-cell resolution and clarify their modern scientific connotations. MethodsFemale non-pregnant CBA/J mice were caged with male BALB/c (blank group) and DBA/2 (modeling group) mice separately. Pregnant mice in the modeling group were randomly grouped as follows: high/low-dose Shoutai Wan, high/low-dose Juyuan Jian, model (RPL), and positive control (dydrogesterone), with 10 mice in each group. Starting from the day after the detection of the vaginal plug, mice were administrated with drugs or an equal volume of normal saline by gavage for 10 consecutive days. After the intervention, the following indicators were measured. ① Macroscopic evaluation: general conditions, uterine wet weight, embryo loss rate, four coagulation parameters [prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), and thrombin time (TT)], and peripheral blood estradiol (E2) and progesterone (Pg) levels. The decidua with embryos was stained with hematoxylin-eosin (HE) and evaluated by transmission electron microscopy (TEM). The expression of B-cell lymphoma-2 (Bcl-2), vascular endothelial growth factor (VEGF), angiotensin Ⅱ (AngⅡ), matrix metalloproteinase-2 (MMP-2), interleukin-6 (IL-6), leukemia inhibitory factor (LIF), CXC chemokine ligand 12 (CXCL12), and microtubule-associated protein 1 light chain 3 homolog (LC3)Ⅰ/Ⅱ was quantified by Western blot. ② Mechanism analysis at the single-cell level: The decidua with embryos from the blank, model, high-dose Shoutai Wan, and high-dose Juyuan Jian groups (6 mice per group, with 3 single-cell samples per group, totaling 24 mice) were analyzed by the BD Rhapsody™ platform, and the whole-cell atlas was drawn by uniform manifold approximation and projection (UMAP) dimensionality reduction clustering combined with the single-cell mouse cell atlas (scMCA). The differentially expressed genes (DEGs) and cell interaction networks were analyzed via Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and CellChat, and the protein-protein interaction (PPI) map of subtype cells was constructed. The CytoTRACE pseudo-temporal analysis was performed to explore the developmental trajectories of core immune cells (natural killer cells, NK cells) from maternal and fetal sources. Results① Pathological and Western blot results indicated that compared with the blank group, the RPL group showed an increase in the embryo loss rate (P<0.01), down-regulated expression of Bcl-2, LIF, MMP-2, and Vegf in the decidua with embryos (P<0.05), up-regulated protein levels of CXCL-12, AngⅡ, and IL-6 (P<0.05), blocked angiogenesis, apoptosis-inflammation imbalance, and coagulation dysfunction. Both prescriptions dose-dependently reduced the abortion rate and restored the angiogenesis-inflammation balance, and Shoutai pill showed superior performance in restoring the E2 level to the Pg level (P<0.05). ② Single-cell transcriptome analysis indicated that compared with the blank group, the RPL group showed differences in multiple key cell populations such as decidual cells, trophoblast cells, endothelial cells, erythroblasts, NK cells, and macrophages at the maternal-fetal interface. Immunity and angiogenesis were the key links in RPL. Compared with the RPL group, high-dose Shoutai Wan reversed the changes of NK cells in the embryonic layer (upregulating the mRNA levels of 17 genes and downregulating the mRNA levels of 29 genes) and macrophages (upregulating the mRNA levels of 117 genes and downregulating the mRNA levels of 53 genes) through the regulation of gene expression. High-dose Shoutai pill regulated the immune cells to affect unfolded proteins, cell adhesion, and programmed cell death, thereby promoting decidualization and angiogenesis and modulating embryo-membrane development. High-dose Juyuan Jian regulated the key subgroups of NK cells (up-regulating the mRNA levels of 9 genes and down-regulating the mRNA levels of 17 genes) and macrophages (up-regulating the mRNA levels of 110 genes and down-regulating the mRNA levels of 81 genes), which affected decidual inflammation and apoptosis and intervened in glycolysis. ③ The pseudo-temporal analysis and communication network indicated that the communication frequency of the RPL group decreased. High-dose Shoutai Wan restored maternal-fetal tolerance through pathways such as NKG2D, CDH5, GDF, and FASLG. High-dose Juyuan Jian enhanced the IL-6/LIFR/JAK/signal transducer and activator of transcription 3 (STAT3) and desmosome/SEMA6/tumor necrosis factor-like weak inducer of apoptosis (TWEAK) signaling to improve endometrial receptivity. The RPL group showed an increased proportion of toxic dNK7, a decreased proportion of reparative dNK4, and blocked embryo fNK1. High-dose Shoutai Wan down-regulated dNK7 and up-regulated dNK4. High-dose Juyuan Jian inhibited the terminal differentiation of dNK7 and up-regulated LILRB1, thus restoring the balance of cytotoxicity and repair. ConclusionBoth the kidney-tonifying and spleen-invigorating methods are effective in treating RPL. NK and macrophages are the key immune cells in the interaction between the embryo and the membrane. The kidney-tonifying method (Shoutai Wan) has an advantage in regulating the phenotypes of unfolded protein, cell adhesion, and programmed cell death, and shows expression characteristics closer to the physiological state in the regulation of NKG2D and CDH5 signals. The spleen-invigorating method (Juyuan Jian) has an advantage in regulating epithelial-mesenchymal transition (EMT), angiogenesis, and glycolysis and shows higher communication intensity in the IL-6 and LIFR pathways.
7.Integrating Transcriptomics and 3D Organoids to Investigate Mechanism of Periplaneta americana Extract Against Lung Adenocarcinoma
Qiong MA ; Chunxia HUANG ; Jiawei HE ; Yuting BAI ; Xingyue LIU ; Yuxuan XIONG ; Yang ZHONG ; Hengzhou LAI ; Yuling JIANG ; Xueke LI ; Qian WANG ; Yifeng REN ; Xi FU ; Funeng GENG ; Taoqing WU ; Ping XIAO ; Fengming YOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(11):124-132
ObjectiveTo evaluate the antitumor activity of Periplaneta americana extract(PAE) against human-derived lung adenocarcinoma organoids(LUAD-PDOs) and to elucidate its potential mechanism based on transcriptomics. MethodsFresh tumor and adjacent normal tissues from patients with LUAD were collected to construct LUAD-PDOs and normal lung organoid(Nor-PDOs) models using 3D organoid culture technology. The effective intervention concentration of PAE was determined using the cell counting kit-8(CCK-8) assay. Experimental groups included the model group(LUAD-PDOs), normal group, model administration group(LUAD-PDOs+PAE), and normal administration group(Nor-PDOs+PAE). Hematoxylin-eosin(HE) staining was used to observe the pathological structures of PDOs, immunohistochemistry(IHC) was performed to detect the expressions of the proliferation marker Ki-67 and lung adenocarcinoma differentiation markers cytokeratin-7(CK-7) and Napsin A, TUNEL staining was applied to detect cell apoptosis. RNA sequencing(RNA-Seq) was conducted to identify differentially expressed genes(DEGs), followed by Gene Ontology(GO), Kyoto Encyclopedia of Genes and Genomes(KEGG), and Gene Set Enrichment Analysis(GSEA), alongside protein-protein interaction(PPI) network analysis to screen core mechanisms. Finally, key targets were validated by integrating external database analysis with immunofluorescence(IF). ResultsNor-PDOs and LUAD-PDOs that highly recapitulated the pathological characteristics of the primary tissues were successfully established. The CCK-8 assay determined that the effective intervention concentration of PAE was 16 g·L-1. Morphological observation showed that Nor-PDOs exhibited lumen-forming structures, whereas LUAD-PDOs displayed dense, solid structures. CCK-8 and TUNEL assays revealed that, compared with the model group, PAE intervention inhibited the proliferation of LUAD-PDOs and promoted apoptosis in LUAD cells, while showing no significant effect on the viability of Nor-PDOs. Transcriptomic analysis identified 719 DEGs that were significantly reversed after PAE intervention(347 up-regulated and 372 down-regulated)(P<0.05). GO enrichment analysis indicated that DEGs in the model administration group were significantly enriched in biological processes related to cell cycle regulation compared to the model group. KEGG pathway analysis revealed that PAE affected pathways related to proliferation and metabolism, including pathways in cancer and the p53 signaling pathway. GSEA further confirmed that PAE significantly enhanced the activity of the p53 signaling pathway(P<0.05). PPI network analysis indicated that breast cancer type 1 susceptibility protein(BRCA1) and checkpoint kinase 1(CHEK1) were the core down-regulated targets in the p53 pathway. IF verified the high expression of BRCA1 and CHEK1 in LUAD-PDOs and their significant downregulation after PAE intervention(P<0.05). Furthermore, survival analysis based on The Cancer Genome Atlas(TCGA) database indicated that low expression of BRCA1 and CHEK1 was significantly associated with prolonged overall survival in patients with LUAD(P<0.05). ConclusionPAE effectively inhibits proliferation of LUAD-PDOs and promotes their apoptosis, its anti-tumor mechanism is potentially associated with the activation of the p53 signaling pathway, with BRCA1 and CHEK1 genes likely serving as key downstream targets for the effects of PAE.
8.Analysis of proficiency testing results for gross alpha and beta radioactivity measurement of radiological laboratories in Shanghai in 2023 and 2024
Minpeng HUANG ; Aijun QIAN ; Fajian LUO ; Qiaochu YANG-FAN ; Linfeng GAO
Shanghai Journal of Preventive Medicine 2026;38(5):372-377
ObjectiveTo evaluate the measurement capability of laboratories of radiological health technical service institutions in Shanghai for determining gross alpha and gross beta radioactivity in water. MethodsAll local laboratories with operational scope covering gross alpha and gross beta radioactivity measurement (hereinafter referred to as "participating laboratories") were organized to undertake a proficiency test. Each participating laboratory measured the gross α and gross β radioactivity concentrations in the proficiency testing water samples using the thick source method specified in GB/T 5750.13‒2023 Standard Examination Methods for Drinking Water—Part 13: Radioactive Indicators. Based on GB/T 28043‒2019 Statistical Methods for Proficiency Testing Using Interlaboratory Comparisons, the measurement results of all participating laboratories were statistically evaluated. The inter-laboratory comparison results for 2023‒2024 were uniformly assessed using z-scores: laboratories with
9.Study on extraction technology of flavonoids from Potentilla discolor with deep eutectic solvents
Bin LIU ; Chenyi YANG ; Meiling SHAO ; Liangyong HUANG ; Yanguo GAO ; Xueqin WANG ; Guanghui LYU ; Qian HU ; Fang YE
China Pharmacy 2026;37(16):2119-2123
OBJECTIVE To optimize the extraction process of flavonoids from Potentilla discolor .METHODS Deep eutectic solvents (DESs) were used as the extraction solvent to prepare test sample solutions. The contents of rutin, quercitrin, and kaempferol were determined by ultra-performance liquid chromatography. The analytic hierarchy process combined with the criteria importance through intercriteria correlation weighting method was employed to assign comprehensive weights to the contents of the three flavonoids, and calculate the comprehensive score. The optimal DESs were screened based on the comprehensive score.Mean while, using the comprehensive score as the response variable and the liquid-to-solid ratio, ultrasonic time, and urltrasonic temperature as the influencing factors, the extraction technology of flavonoids from P.discolor was optimized by Box-Behnken response surface methodology and subsequently validated.RESULTS The comprehensive weight coefficients of rutin, quercitrin, and kaempferol were 0.646 7, 0.207 5, and 0.145 8, respectively. The optimal DESs were choline chloride-lactic acid (molar ratio 1∶4) with a water content of 40%. The optimal extraction conditions were determined as follows: liquid-to-solid ratio of 25∶1, ultrasonic time of 40 min, and ultrasonic temperature of 50 ℃. The validation results showed that the average comprehensive score of three batches of samples was 99.28, with an RSD of 0.54% ( n =3).CONCLUSIONS The optimal extraction technology of flavonoids from P. discolor based on DESs obtained in this study was stable and feasible.
10.Randomized Controlled Study on Wenshen Yangxue Decoction Plus Endometrial Microstimulation for Polycystic Ovary Syndrome (PCOS) Infertility with Syndrome of Kidney-Yang Deficiency and Blood Stasis
Qianqian HUANG ; Qian HAN ; Mingwei XIN ; Junqin HE ; Jingshang WANG ; Xiaodan YIN ; Mengyuan LI ; Yanxiao YI ; Yanli TANG ; Yiting WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):181-190
ObjectiveTo evaluate the clinical efficacy and safety of Wenshen Yangxue decoction combined with endometrial microstimulation in the treatment of infertile patients with polycystic ovary syndrome (PCOS, syndrome of kidney-Yang deficiency and blood stasis). MethodsA randomized, positive-drug parallel-controlled, open-label clinical study was conducted. A total of 240 infertile PCOS patients with the syndrome of kidney-Yang deficiency and blood stasis who met the inclusion and exclusion criteria were randomly assigned into 4 groups, with 60 patients in each group. The control group was treated with clomiphene citrate (50-100 mg·d-¹, orally for 5-10 consecutive days) for ovulation induction. On the basis of the therapy in the control group, the Wenshen group was additionally treated with Wenshen Yangxue decoction (250 mL, warm oral administration, twice daily, in the morning and evening), and the stimulation group received endometrial microstimulation during the early follicular phase. The combined group was treated with clomiphene citrate plus Wenshen Yangxue decoction (at the same dosages as aforementioned) and endometrial microstimulation. The course of treatment for all the groups was 3 menstrual cycles. The pregnancy rate, ovulation status, sex hormone levels, glucose metabolism indicators, coagulation function, endometrial thickness, traditional Chinese medicine (TCM) symptom scores, and adverse reactions were observed in each group. ResultsA total of 239 patients were included in the final analysis, with 59 patients in the Wenshen group and 60 patients in each of the other three groups. The pregnancy rates were 43.3%(26/60) in the combined group and 32.2%(19/60) in the Wenshen group, both significantly higher than that (10%) in the control group (χ2=17.56,P<0.01). Compared with the control group, the combined and Wenshen groups had increased mature follicle rates (P<0.01), while the Wenshen group showed a decreased luteinization rate (P<0.05). All the groups exhibited significant reductions in TCM symptom scores after treatment, and the Wenshen and combined groups had lower scores than the control group (P<0.01). No statistically significant difference was found in the incidence of adverse events among the four groups, and all the adverse events were mild. ConclusionWenshen Yangxue decoction combined with endometrial microstimulation can alleviate the TCM symptoms of infertile PCOS patients with the syndrome of kidney-Yang deficiency and blood stasis, promote follicular maturation and ovulation, increase the cumulative pregnancy rate, and has good safety. It can provide new clinical evidence for the integrated traditional Chinese and Western medicine treatment of PCOS infertility.

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